Cardiovascular (CV) disease affects one in three adults in the US and its treatments are often complex, expensive, and difficult to consistently deliver with high quality. Our DCRI CERTs goals are to expand the knowledge and use of evidence-based therapeutics in four high-priority CV conditions: atrial fibrillation (AF);acute coronary syndrome (ACS);heart failure (HF);and high blood pressure (HBP). Our proposal addresses all of AHRQ's Programmatic Interests: safety, comparative effectiveness research (CER), tool development, health system intervention, and translation to practice. To achieve our goals, we have established collaborations with the major CV professional societies, governmental agencies, payers and pharmacy benefit managers that can be leveraged to create and support a national, longitudinal data platform. Using this platform, we propose to study national CV care and carry out a series of important CER and safety studies. We also propose to develop, implement, and evaluate novel quality improvement tools. These focus on using data and feedback to engage both patients and providers. Once proven, our interventions are sustainable and can be disseminated nationally via our CV society partners. Our Specific Aims are to: 1. Create novel national 'longitudinal data platforms'for the study of AF, ACS, HF, and HBP; 2. Apply these data platforms to conduct high quality CER and safety studies that address existing and emerging CV therapeutic issues; 3. Design and evaluate novel tools and implementation strategies to empower patients and providers to more effectively, safely and efficiently use evidence-based CV therapeutics; 4. Work with medical society, government, and other partners to disseminate and sustain those interventions found to be most effective; 5. Collaborate with other CERT centers and partners to advance research methodology, carry out crosscutting research, and train the next generation of CV researchers and leaders. PUBLIC HEALTH RELEVANCE: Our proposal uses existing large clinical, claims, and pharmacy datasets to generate new knowledge regarding the comparative safety and effectiveness of current and emerging CV therapeutics. We also propose to develop and evaluate several patient- and provider-education and feedback tools to improve the quality and consistency of cardiovascular care on a national scale.